Health bill boosts Medicaid cost

WASHINGTON - Financially struggling states such as Ohio would face higher Medicaid costs during the next decade under a sweeping health-care reform package unveiled yesterday by House Democrats.

WASHINGTON - Financially struggling states such as Ohio would face higher Medicaid costs during the next decade under a sweeping health-care reform package unveiled yesterday by House Democrats.

The House measure, which could be voted on as early as next week, extends health coverage to nearly 96 percent of Americans in large part by providing federal financial assistance to help families of four earning as much as $88,200 a year buy their own insurance.

But in a section likely to provoke opposition from many governors, the proposal would increase Medicaid eligibility from 100 percent of the federal poverty rate to 150 percent -- meaning a family of four earning $33,100 a year could enroll in Medicaid.

Thus, tens of thousands more people in Ohio would become eligible for Medicaid, a program that pays health coverage for the poor and is jointly financed by federal and state governments.

Under the bill, the federal government would pay 100 percent of the additional Medicaid costs for 2013 and 2014. But after 2014, the federal government would pay just 91 percent, forcing Ohio and other states to pay the rest. That tab has not been calculated.

"Obviously, the expansion of Medicaid is a concern for the states, particularly how it's going to be funded and what the eligibility expansion looks like," said Michelle Blackston, a spokeswoman for the National Conference of State Legislatures. "Medicaid (expansion) is one of our top priorities ... it must be fully funded by the federal government."

Ohio House Minority Leader William Batchelder wrote Gov. Ted Strickland yesterday warning that making more Ohioans eligible for Medicaid would "cause Medicaid costs and state taxes to certainly skyrocket." The Medina Republican urged the governor to oppose the congressional health-reform bills.

Although Strickland earlier this fall acknowledged that Ohio is "not in a position to accept additional Medicaid responsibilities," Amanda Wurst, a spokeswoman for the governor, said yesterday, "We have not had the opportunity to review the House version of the bill. But the governor believes the (health-care) system is broken and steps should be taken to address health-insurance reform in our country."

The House bill has a number of similarities to a Senate measure rolled out this week by Senate Majority Leader Harry Reid, D-Nev. Both extend coverage to a sizable number of the 46 million people in the United States without health insurance. Both provide federal subsidies to middle-income people to buy insurance, and both expand eligibility for Medicaid.

But the Senate version would cap Medicaid eligibility at $29,300 for a family of four, meaning fewer people in Ohio could enroll in the program. Even under the Senate bill, Ohio could face additional Medicaid costs of $922 million during the first five years.

House Democrats crafted their 1,990-page bill from the work of three House committees, putting Congress one step closer to approving the most sweeping overhaul of the nation's health-care system since the 1965 creation of Medicare. The measure would cost $900 billion during the next decade.

At a rally outside the U.S. Capitol, House Speaker Nancy Pelosi, D-Calif., said, "We are able to deliver on the promise of making affordable, quality health care available for all Americans, laying the foundation for a brighter future for generations to come."

Although virtually every Republican is expected to oppose it, Pelosi is thought to be close to winning the backing of the 218 Democrats needed to pass the measure.

The bill would prohibit private insurance companies from denying coverage based on pre-existing health conditions, would provide federal dollars to middle-income families to help them buy insurance, and would extend government and private coverage to an additional 36 million Americans.

A major feature of the bill is the new federal insurance plan to compete with the private sector. The so-called "public option" would be part of a health exchange that would include private plans and would be available to people who currently do not receive insurance from their companies or pay for their own insurance.

Rep. Mary Jo Kilroy, D-Columbus, who joined Pelosi and other Democrats at the Capitol Hill event, reminded the audience that she has been "diagnosed with multiple sclerosis. And I've been lucky because I've had the benefits of health insurance."

"But I also know that with many people that is not the case," Kilroy said. "They are excluded from the health-insurance system because they have a pre-existing condition and can't afford the medications that would ... allow them to live their lives to the fullest."

To finance the measure, House Democrats want to impose new taxes on individuals making more than $500,000 a year and families earning more than $1 million annually. The bill would mandate that most Americans buy insurance and would fine those who do not.

In addition, it would fine companies with annual payrolls of more than $500,000 who do not offer their workers insurance. It also would limit contributions to federal health-savings accounts to $2,500 annually.

House Minority Leader John Boehner, R-West Chester, charged that the bill is "going to raise the cost of American health insurance. It's going to kill jobs with tax hikes and new mandates in it."